Assignment 2: Practicum: Decision Tree

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USW1.5698.202150 - PRAC-6670-2/PRAC-6670A-2-PMH NP Role II: Adult-QTR-Term-wks-1-thru-11-(03/01/2021-05/16/2021)-PT27

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Silifat Jones-Ibrahimon Thu, Apr 15 2021, 6:54 PM 68% highest match Submission ID: 5d4c0b5e-b2e4-4021-9f55-3a2b4c7dd62b

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WK7Assgn2JonesIbrahimS (2).docx

Running head: PRACTICUM: 1 DECISION TREE 1 PRACTICUM: 2 DECISION TREE 2 Practicum: Decision Tree: The Case Study: 3 A Young Woman with Depression Silifat Jones-Ibrahim College of Nursing-PMHNP, Walden University PRAC 6670: 4 Psychiatric Mental Health Nurse Practitioner Role II - Adults and Older Adults Dr Mihaela Fletcher The Case Study: 3 A Young Woman with Depression The discussion below will examine the case of Stefani, a 32-year-old lady who was brought to the facility. The paper will develop three decisions, including differential diagnosis, pharmacological treatment, and their rationale, as well as highlight the bioethical principles considered while communicating with the patient alongside the family and in the treatment process. Decision #1: Differential Diagnosis 5 Decision - Cyclothymic disorder 6 Reason for this Decision 7 A patient who complains of mood swings for more than two years may have a mild form of the bipolar disorder known as a cyclothymic disorder. 8 The underlying manifestations of mood swings occur between hypomania and depression with a short period of regular activity and irritability in between. Individuals at risk of Cyclothymic disorder have a 15-50% possibility of developing bipolar type 1 disorder and usually starts in adolescence (American Psychiatric Association, 2013). The behaviors expressed by individuals with this disorder are alcohol abuse and other substance abuse. Additionally, dilettantism and religious cults are historical information describing these patients (APA, 2013). 8 What was Hoping to Achieve by Making this Decision Stephanie (patient) is a 32-year-old Hispanic female from Puerto Rican. She is always prepared with the right weather dress. She speaks coherently, clear, and goal-directed. She quickly responds to questions. She has a stable and normal gait, as confirmed by her neurological assessment. Has no history of attempting suicidal or homicidal ideation. Reported to experience no visual or auditory hallucinations (Perugia, Hantouchec & Vannucchia, 2017). 8 In the past two years, Stephanie has been complaining of the following issues. Occasionally, she experiences depression that presents hypomanic phases with increased fatigue, energy, and sadness when she struggles to focus and think straight. On some days, she complains of lacking sleeping, like 3 hours every day, while on some days she sleeps well. Furthermore, she has an enhanced goal-directed activity and distractibility, clear manifestations that she is suffering from Cyclothymic disorder (Eling, 2017). 9 Difference between Expected outcome and Achieve outcome with Decision #1 10 The expected and achieve outcome had no significant difference. The underlying symptoms indicating that she has Cyclothymic disorder include mood swings, persistence between depression and hypomania; 10 enhanced goal-directed activity; decreased need for sleep, distractibility, high energy, and fatigue. Decision #2: 6 Treatment Plan for Psychotherapy Begin Abilify 10mg orally daily Reason for this Decision Abilify is prescribed for quick relief and improvement of manic and psychotic symptoms. 11 However, it takes several weeks for full effect on affective stabilization, cognition, and behavior. 8 When dopamine concentrations are low, it increases its output, thus improving the affective symptoms, behavior, and cognition (Stahl, 2018). When the concentrations are high, it lowers the dopamine output, which improves positive symptoms and antipsychotic actions (Stahl, 2018). In some patients, the effect starts to be felt between 4-6 weeks, while in those treating cognitive symptoms, the medication effect is felt between 16-20 weeks. It is essential to educate the patient about the adverse effects of the drug. 9 After the patient starts the medication, the primary care provider must check within the first three months about Stephanie’s fasting lipid profile, fasting plasma glucose, weight, and baseline of blood pressure (Perugia, Hantouchec & Vannucchia, 2017). 10 Some of the patient's medication side effects are headache, vomiting, nausea, sedation, hypotension, and dizziness. In order to help Stephanie properly manage her mood swings, she needs to be referred to a psychotherapist who will help her cope with mood swings and increase her diagnosis awareness. Also, these informed decisions will reduce the patient’s risk of developing full-blown manic attacks (Eling, 2017). 8 What was Hoping to Achieve by Making this Decision? The goal expected to be achieved by prescribing Abilify is to stabilize Stephanie’s mood swings, control and prevent the development of a full-blown maniac, and enhance her ability to think well. On her 4th week of facility visit, it is expected that her expressions of feeling will improve. 6 The Difference between what is Expected and the Achieve outcome with Decision #2 Similar results were recorded from both the achieved and the expected outcomes. 8 It was expected that, after prescribing the medication, Stephanie would complain less about its side effect and symptoms of Cyclothymic disorder. However, upon returning to the clinic on the 4th week, Stephanie said she does not feel after taking the medication, although she complained of feeling dizzy. Decision #3: 12 Treatment Plan for Psychopharmacology 6 Maintain current dose of Abilify Reason for Decision Since drugs' side effects are disappearing and the medication makes the patient feel fine, it is crucial to continue with the exact dosage. The patient will not get the full benefit of the medication when it is halted or increased. Therefore, the goal is to monitor her progress through follow-up. 8 What was Hoping to Achieve by Making this Decision? The primary goal and the expected outcome for continuing with Abilify dosage are to reduce the patient’s symptoms and halt relapse of Cyclothymic symptoms. 8 Expected Result with this Decision. The patient's expected outcome is to prevent relapse, continue with the medication, to continue experiencing little or no side effects of the medication. Also, her behavioral symptoms are expected to improve as she continues to attend psychotherapy sessions. 6 Difference between Expected Result and the Achieved Result with Decision Similar outcomes for achieved and expected results were recorded. After returning to the clinic, she confirmed that her sadness and other issues had disappeared as well as decreased symptoms. Ethical Considerations 8 While providing care for Ms Stephanie, it is crucial to consider the ethical aspect of nonmaleficence, autonomy, and beneficence (Eling, 2017). The goal is to provide the best treatment without inflicting any harm or fear. 6 It is also necessary to respect Stephanie’s autonomy when providing care. References 13 American Psychiatric Association. (2013). 14 Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub. Eling, P. (2017). 14 Synopsis of psychiatry: Behavioral sciences/clinical psychiatry. Tijdschrift voor Neuropsychologie, 10(1). 12 Perugia, G., Hantouchec, E., & Vannucchia, G. (2017). 15 Diagnosis and treatment of cyclothymia: 16 the “primacy” of temperament. Current Neuropharmacology, 15(3), 372-379. Stahl, S. M. (2018). Prescriber's Guide Children and Adolescents: 17 Stahl's Essential Psychopharmacology. 8 Cambridge University Press.

Citations (17/17)

  1. 1 Another student's paper
  2. 2 Another student's paper
  3. 3 Another student's paper
  4. 4 Another student's paper
  5. 5 https://www.essays24.com/essay/Cyclothymic-Disorder/22818.html
  6. 6 Another student's paper
  7. 7 https://www.winoverdepression.com/difference-between-cyclothymia-and-depression/
  8. 8 Another student's paper
  9. 9 Another student's paper
  10. 10 Another student's paper
  11. 11 Another student's paper
  12. 12 Another student's paper
  13. 13 https://www.achievesolutions.net/achievesolutions/en/Content.do?contentId=4001
  14. 14 http://www.minddisorders.com/Br-Del/Cyclothymic-disorder.html
  15. 15 https://www.therecoveryvillage.com/mental-health/cyclothymic-disorder/
  16. 16 https://psychcentral.com/disorders/cyclothymic-disorder-cyclothymia/cyclothymic-disorder-treatment/
  17. 17 https://writemyassignments.org/blog/2018/09/10/assessing-and-treating-adult-and-geriatr/

Matched Text

Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx DECISION TREE 1 Source - Another student's paper Decision Tree 1 Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx DECISION TREE 2 Source - Another student's paper DECISION TREE 2 Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx A Young Woman with Depression Source - Another student's paper A Young Woman with Depression Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx A Young Woman with Depression Source - Another student's paper A Young Woman with Depression Suspected Entry: 86% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx The discussion below will examine the case of Stefani, a 32-year-old lady who was brought to the facility Source - Another student's paper The discussion below will examine a case of Ms Stefani, a 32-year-old lady who was brought to the clinic Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx The paper will develop three decisions, including differential diagnosis, pharmacological treatment, and their rationale, as well as highlight the bioethical principles considered while communicating with the patient alongside the family and in the treatment process Source - Another student's paper The paper will develop three decisions including differential diagnosis, pharmacological treatment, and their rationale as well as highlight the bioethical principles considered while communicating with the patient alongside the family and in the treatment process Suspected Entry: 68% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx Psychiatric Mental Health Nurse Practitioner Role II - Adults and Older Adults Dr Mihaela Fletcher Source - Another student's paper Psychiatric Mental Health Nurse Practitioner Role II Suspected Entry: 69% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx Decision - Cyclothymic disorder Source - https://www.essays24.com/essay/Cyclothymic-Disorder/22818.html "Cyclothymic Disorder." Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx Reason for this Decision Source - Another student's paper Reason for this Decision Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx Treatment Plan for Psychotherapy Source - Another student's paper Treatment Plan for Psychotherapy Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx Begin Abilify 10mg orally daily Source - Another student's paper Begin Abilify 10mg orally daily Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx Reason for this Decision Source - Another student's paper Reason for this Decision Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx The Difference between what is Expected and the Achieve outcome with Decision #2 Source - Another student's paper The Difference between what is Expected and the Achieve outcome with Decision #2 Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx Maintain current dose of Abilify Source - Another student's paper Maintain current dose of Abilify Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx Reason for Decision Source - Another student's paper Reason for Decision Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx Difference between Expected Result and the Achieved Result with Decision Source - Another student's paper Difference between Expected Result and the Achieved Result with Decision Suspected Entry: 64% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx It is also necessary to respect Stephanie’s autonomy when providing care Source - Another student's paper respect the autonomy of patients when providing care Suspected Entry: 66% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx A patient who complains of mood swings for more than two years may have a mild form of the bipolar disorder known as a cyclothymic disorder Source - https://www.winoverdepression.com/difference-between-cyclothymia-and-depression/ If you have been experiencing a steady cycling of mild mood changes for two years or more, you may have a lesser form of Bipolar Disorder known as cyclothymia or cyclothymic disorder Suspected Entry: 73% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx The underlying manifestations of mood swings occur between hypomania and depression with a short period of regular activity and irritability in between Source - Another student's paper The patient has a fluctuating mood swing between depression and hypomania with irritability and a short period of regular activity in between Suspected Entry: 67% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx Individuals at risk of Cyclothymic disorder have a 15-50% possibility of developing bipolar type 1 disorder and usually starts in adolescence (American Psychiatric Association, 2013) Source - Another student's paper The Cyclothymic disorder starts in adolescence with 15 to 50 percent possibility of developing bipolar type 1 (Tracy, 2012) Suspected Entry: 67% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx The behaviors expressed by individuals with this disorder are alcohol abuse and other substance abuse Source - Another student's paper Patient with this disorder is known to abuse alcohol and other substance abuse Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx What was Hoping to Achieve by Making this Decision Source - Another student's paper What was Hoping to Achieve by Making this Decision Suspected Entry: 77% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx Stephanie (patient) is a 32-year-old Hispanic female from Puerto Rican Source - Another student's paper What was Hoping to Achieve by Making this Decision The patient (Stephanie) is a 32-year-old Hispanic female from Puerto Rican Suspected Entry: 76% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx In the past two years, Stephanie has been complaining of the following issues Source - Another student's paper Patient Stephanie has been having the following issues for the past two years Suspected Entry: 63% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx When dopamine concentrations are low, it increases its output, thus improving the affective symptoms, behavior, and cognition (Stahl, 2018) Source - Another student's paper It increases dopamine output when the concentrations are low, consequently enhancing cognitive, behavioral and affective symptoms Suspected Entry: 70% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx When the concentrations are high, it lowers the dopamine output, which improves positive symptoms and antipsychotic actions (Stahl, 2018) Source - Another student's paper It also reduces dopamine output when the concentrations are high, therefore improving mediating antipsychotic actions and positive symptoms (Stahl, 2014) Suspected Entry: 63% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx In some patients, the effect starts to be felt between 4-6 weeks, while in those treating cognitive symptoms, the medication effect is felt between 16-20 weeks Source - Another student's paper The efficacy of the medication shows between 4–6 weeks for some patient but takes up to 16–20 weeks to show the effect on cognitive symptoms Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx What was Hoping to Achieve by Making this Decision Source - Another student's paper What was Hoping to Achieve by Making this Decision Suspected Entry: 63% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx It was expected that, after prescribing the medication, Stephanie would complain less about its side effect and symptoms of Cyclothymic disorder Source - Another student's paper The medication was reduced the symptoms of cyclothymic disorder and the side effect was expected Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx What was Hoping to Achieve by Making this Decision Source - Another student's paper What was Hoping to Achieve by Making this Decision Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx Expected Result with this Decision Source - Another student's paper Expected Result with this Decision Suspected Entry: 62% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx The patient's expected outcome is to prevent relapse, continue with the medication, to continue experiencing little or no side effects of the medication Source - Another student's paper The expected result is that the patient will continue to do well with the medication with little or no side effect and prevent relapse Suspected Entry: 67% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx While providing care for Ms Stephanie, it is crucial to consider the ethical aspect of nonmaleficence, autonomy, and beneficence (Eling, 2017) Source - Another student's paper Ethical Considerations It is crucial to consider the following ethical issue while providing care for this patient which beneficence, autonomy, and nonmaleficence Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx Cambridge University Press Source - Another student's paper Cambridge University Press Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx Difference between Expected outcome and Achieve outcome with Decision #1 Source - Another student's paper Difference between Expected outcome and Achieve outcome with Decision #1 Suspected Entry: 69% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx After the patient starts the medication, the primary care provider must check within the first three months about Stephanie’s fasting lipid profile, fasting plasma glucose, weight, and baseline of blood pressure (Perugia, Hantouchec & Vannucchia, 2017) Source - Another student's paper Stahl (2014) states that the baseline of blood pressure, weight, fasting plasma glucose, and fasting lipid profile must be taken and check within three months after starting the medication Suspected Entry: 64% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx The expected and achieve outcome had no significant difference Source - Another student's paper There is no difference between the expected outcome and the achieve an outcome Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx enhanced goal-directed activity Source - Another student's paper enhanced goal-directed activity Suspected Entry: 76% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx Some of the patient's medication side effects are headache, vomiting, nausea, sedation, hypotension, and dizziness Source - Another student's paper effects (dizziness, hypotension, sedation, nausea, vomiting, headache Suspected Entry: 68% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx However, it takes several weeks for full effect on affective stabilization, cognition, and behavior Source - Another student's paper However, it takes a couple of weeks to affect cognition, behavior, and affective stabilization fully Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx Treatment Plan for Psychopharmacology Source - Another student's paper Treatment Plan for Psychopharmacology Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx Perugia, G., Hantouchec, E., & Vannucchia, G Source - Another student's paper Perugia, G., Hantouchec, E., & Vannucchia, G Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx American Psychiatric Association Source - https://www.achievesolutions.net/achievesolutions/en/Content.do?contentId=4001 American Psychiatric Association Suspected Entry: 82% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx Diagnostic and statistical manual of mental disorders (DSM-5®) Source - http://www.minddisorders.com/Br-Del/Cyclothymic-disorder.html Diagnostic and Statistical Manual of Mental disorders Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx Synopsis of psychiatry Source - http://www.minddisorders.com/Br-Del/Cyclothymic-disorder.html Synopsis of Psychiatry Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx Behavioral sciences/clinical psychiatry Source - http://www.minddisorders.com/Br-Del/Cyclothymic-disorder.html Behavioral Sciences/Clinical Psychiatry Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx Diagnosis and treatment of cyclothymia Source - https://www.therecoveryvillage.com/mental-health/cyclothymic-disorder/ “Diagnosis and treatment of cyclothymia Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx the “primacy” of temperament Source - https://psychcentral.com/disorders/cyclothymic-disorder-cyclothymia/cyclothymic-disorder-treatment/ The “Primacy” of Temperament Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx Current Neuropharmacology, 15(3), 372-379 Source - https://psychcentral.com/disorders/cyclothymic-disorder-cyclothymia/cyclothymic-disorder-treatment/ Current neuropharmacology, 15, 3 372–379 Suspected Entry: 100% match Uploaded - WK7Assgn2JonesIbrahimS (2).docx Stahl's Essential Psychopharmacology Source - https://writemyassignments.org/blog/2018/09/10/assessing-and-treating-adult-and-geriatr/ Stahl’s essential psychopharmacology